PERMANENTE MEDICAL GROUP INC (NPI# 1548343510) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548343510 |
| Entity Type | Organization |
| Organization Name | PERMANENTE MEDICAL GROUP INC |
| Practice Address |
7373 West Lane Stockton CA 95210-3377 |
| Mailing Address |
1950 Franklin St Tpmg Financial Management 18th Flr Oakland CA 94612-5103 |
| Practice Telephone | 2094762000 |
| Mailing Telephone | 5109871000 |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2020-07-13 |
| Authorized Official Name | MS. PATRICIA T WEST (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 5102957207 |
| Is Organization Subpart | Y |
| Parent Organization Name | PERMANENTE MEDICAL GROUP, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| N | 207L00000X | Anesthesiology | Allopathic & Osteopathic Physicians | ||
| N | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians | ||
| N | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
| N | 207W00000X | Ophthalmology | Allopathic & Osteopathic Physicians | ||
| N | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians | ||
| N | 207Y00000X | Otolaryngology | Allopathic & Osteopathic Physicians | ||
| N | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 208100000X | Physical Medicine & Rehabilitation | Allopathic & Osteopathic Physicians | ||
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians | ||
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GR0015723 | 05 | |
| CA | GRN00011A | 05 | |
| CA | LAB04213F | 05 | |
| CA | LAB89878F | 05 | |
| CA | GR0015729 | 05 | |
| CA | GR001572C | 05 | |
| CA | GR001572R | 05 | |
| CA | ZZZ83648Z | 05 | |
| CA | GR0015720 | 05 | |
| CA | GR001572G | 05 | |
| CA | GR0015724 | 05 | |
| CA | GRN000118 | 05 | |
| CA | ZZZ20738Z | 05 | |
| CA | GR001572H | 05 | |
| CA | GR0046722 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841373800 | Permanente Medical Group Inc | Anesthesiology | 2238 Geary, San Francisco, CA 94116-3416 | 2006-10-23 |
| 1235226531 | Permanente Medical Group Inc | Surgery | 901 Nevin, Richmond, CA 94801-3143 | 2006-10-06 |
| 1336222397 | Permanente Medical Group Inc | Anesthesiology | 975 Sereno Drive, Vallejo, CA 94589-2441 | 2006-10-23 |
| 1639252604 | Permanente Medical Group Inc | Anesthesiology | 1190 Veterans Blvd, Redwood City, CA 94063-2037 | 2006-10-23 |
| 1073606299 | Permanente Medical Group Inc | Ophthalmology | 710 Lawrence Expressway, Santa Clara, CA 95051-5173 | 2006-10-02 |
| Street Address |
7373 WEST LANE |
| City | STOCKTON |
| State | CA |
| Zip Code | 95210-3377 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427059849 | Linda Hurst | Nurse Practitioner | 7373 West Lane, Stockton, CA 95210-3377 | 2005-08-09 |
| 1215410964 | Nelda Trejo | Marriage & Family Therapist | 7373 West Lane, Tommydon Bldg, Stockton, CA 95210 | 2018-09-10 |
| 1396140851 | Linda Jo Skipp | Registered Nurse | 7373 West Lane, Kaiser Permanente Outpatient Surgery, Stockton, CA 95210 | 2014-10-27 |
| 1255609707 | Jesse Wade Thiboutot | Pharmacist | 7373 West Lane, Pharmacy 1, Stockton, CA 95210 | 2011-12-12 |
| 1649468851 | Matangi Venkateswaran | Pharmacist | 7373 West Lane, Stockton, CA 95210-3377 | 2007-10-12 |
| 1962623207 | Marleen Anne Yu-li | Pediatrics | 7373 West Lane, Stockton, CA 95219 | 2007-05-02 |
| 1093832636 | Amit Parekh | Internal Medicine | 7373 West Lane, Stockton, CA 95210 | 2007-03-26 |
| 1811053176 | Cristie Kay Crawford | Dietitian, Registered | 7373 West Lane, Kaiser Permanente, Health Education, Stockton, CA 95210 | 2006-12-29 |
| 1619036530 | Troy Hamilton | Audiologist | 7373 West Lane, Stockton, CA 95210-3377 | 2006-12-06 |
| 1902973035 | Josilin Mathew | Physical Therapist | 7373 West Lane, Physical Therapy Dept #175, Stockton, CA 95210 | 2006-11-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063021970 | Leslie Jazmin Marin | Student in an Organized Health Care Education/Training Program | 7109 Danny Dr, Stockton, Stockton, CA 95210 | 2020-07-27 |
| 1043866692 | Alexis Thomasson | Behavior Technician | 7109 Danny Drive, Stockton, CA 95210 | 2019-08-09 |
| 1821651324 | Maria Guadalupe Toledo | Lactation Consultant, Non-RN | 7912 Hammer Lane, Stockton, CA 95210 | 2019-04-19 |
| 1508226440 | Active Life Adult Day Care, Inc. | Clinic/Center | 7209 Tam O'shanter Dr., Stockton, CA 95210 | 2016-03-04 |
| 1548631260 | Rachel Standley | Substance Abuse Rehabilitation Facility | 8017 El Cajon St, Stockton, CA 95210 | 2015-10-08 |
| 1225435308 | Active Life Medical Produtcs Inc | Durable Medical Equipment & Medical Supplies | 611 W Grider Way, Stockton, CA 95210 | 2014-12-04 |
| 1942633318 | Kimberly Ruiz Dizon | Physician Assistant | 1530 E Hammer Ln, Stockton, CA 95210 | 2013-08-20 |
| 1285920983 | Supplemental Health Care | Preferred Provider Organization | 8425 Kiltie Wy, Stockton, CA 95210 | 2011-06-22 |
| 1770807901 | Stockton Medical Weight Loss Center Inc | Internal Medicine | 1801 E. March Lane, Suite 400d, Stockton, CA 95210 | 2010-03-17 |
| 1699911412 | Pratap Krishna Anne | Pharmacist | 1801 E.march Ln, Suite:b280, Bjrx, Stockton, CA 95210 | 2008-12-29 |
| Find all providers in zip 95210 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255956132 | Adventist Health Physicians Network | Internal Medicine | 10200 Trinity Pkwy Ste 102, Stockton, CA 95219-7287 | 2020-06-16 |
| 1750773792 | Centurion Valley Healthcare Inc. | Internal Medicine | 6337 Brook Hollow Cir, Stockton, CA 95219-2441 | 2015-02-27 |
| 1134477599 | Mahboob Ali | Internal Medicine | 1801 E March Ln Ste A170, Stockton, CA 95210-6673 | 2012-08-16 |
| 1841586781 | Brian Aloyisus Boyle | Internal Medicine | 112 Dunkard Church Rd, Stockton, NJ 08559-1406 | 2011-06-20 |
| 1154635506 | Shalini Madugundi | Internal Medicine | 2015 E Mariposa Rd, Stockton, CA 95205-7735 | 2010-07-27 |
| 1952534927 | Geriatrics Long Term Care Medical Corporation | Internal Medicine | 1240 Robinhood Drive, Suite A, Stockton, CA 95207-5507 | 2009-08-25 |
| 1558504514 | Ivan Safonoff | Internal Medicine | 90 Stompf Tavern Rd, Stockton, NJ 08559-1801 | 2009-04-07 |
| 1427212653 | Connie Tang Singh | Internal Medicine | 1801 E March Ln Ste C310, Stockton, CA 95210-6683 | 2008-07-16 |
| 1285897892 | Rashaad Ahmed Chothia | Internal Medicine | 415 E Harding Way Ste I, Stockton, CA 95204 | 2008-07-03 |
| 1346400546 | Swetha Ramachandran | Internal Medicine | 5049 Pine Lake Ct, Stockton, CA 95219-2030 | 2008-06-11 |
| Find all providers in STOCKTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.